1 JULI 2 7 8 5 4 4 4 4 4 4 4 0
2 AGUSTUS 7 4 8 3 1 1 1 1 1 1 1 0
3 SEPTEMBER 2 2 8 1 1 1 1 1 1 1 1 0
4 OKTOBER 9 2 10 1 1 1 1 1 1 1 1 0
5 NOVEMBER 4 6 16 6 6 6 6 6 6 6 6 0
6 DESEMBER 5 2 8 0 0 0 0 0 0 0 0 0
TOTAL 29 23 58 16 13 13 13 13 13 13 13 0
LIMA
0 0 0 4 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 0
0 0 0 6 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 13 0 0 0 0 0 0 0
Kab/Kota : Jember
Propinsi : Jawa Timur
Booster AKBK/
POLIO 4 IPV MR MR Lanjutan Suntik TT/Td IUD Suntik Pil Lain-lain Remaja PUS
Pentabio IMPLAN
0 0 0 0 0 0 0 0 21 0 0 0 0
0 0 0 0 0 0 0 1 46 0 0 0 0
0 0 0 0 0 0 0 2 38 0 0 0 0
0 0 0 0 0 0 0 0 48 0 0 0 0
0 0 0 0 0 0 0 0 32 0 0 0 0
0 0 0 0 0 0 0 1 32 0 0 0 0
0 0 0 0 0 0 0 4 217 0 0 0 0
ehatan Reproduksi
Usia > 50
WUS
Tahun
0 0
0 0
0 0
0 0
0 0
0 0
0 0
FORM 5
LAPORAN DETEKSI RESIKO TINGGI PERSALINAN BIDA
SEMESTER II TAHUN 2023
Nama Bidan Delima : Nurul Fitri Hidayati Amd.,Keb
Ranting : Sabrang
No. Sertifikat :
1 JULI 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0
2 AGUSTUS 2 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0
3 SEPTEMBER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 OKTOBER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 NOVEMBER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 DESEMBER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0
INAN BIDAN DELIMA
23
Kab/Kota : Jember Kab/Kota :
Propinsi : Jawa Timur Propinsi :
0 0 1 0 0 0 0
0 0 2 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 3 0 0 0 0
Jember
Jawa Timur
FORM 6
LAPORAN PELAYANAN NEONATUS BERMASALAH DI BID
SEMESTER II TAHUN 2023
Nama Bidan Delima : Nurul Fitri Hidayati Amd.,Keb
Ranting : Sabrang
No. Sertifikat :
Jenis Komplikasi (sesuai 18 penapisan)
Jumlah Tertangani di
No. Bulan
Komplikasi 1 2 3 4 5 6 7 8 9 10 11 12 13 TPMB
1 JULI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 AGUSTUS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 SEPTEMBER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 OKTOBER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 NOVEMBER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 DESEMBER 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SALAH DI BIDAN DELIMA
023
Kab/Kota : Jember
Propinsi : Jawa Timur
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
Kab/Kota : Jember
Propinsi : Jawa Timur